Monitoring of myocardial revascularization

• US 6,200,310 B1
• Filed: 12/07/1998
• Issued: 03/13/2001
• Est. Priority Date: 01/08/1997
• Status: Expired due to Term

• Current Assignee: US Bioscience
• Original Assignee: Biosense, Inc. (Cardinal Health, Inc.)
• Inventors: Ben-Haim, Shlomo, Yaron, Uri, Zilberstein, Joel
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US09/142,696
• Time in Patent Office: 827 Days
• Field of Search: 606/15, 606/17, 606/41, 606/49, 606/33, 606/10, 606/12, 606/7, 607/89, 607/101, 607/122
• US Class Current: 606/10
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4488 the transducer being a phased array
• CPC Class Codes: A61N 5/0601 Apparatus for use inside the body

Abstract

Apparatus for PNR treatment, including an elongate probe having a distal end for engaging heart tissue of a subject, and a revascularization device, which imparts energy to the heart tissue for generating perfusion-enhancing channels therein. A sensor provides an indication responsive to the treatment, preferably by receiving signals generated by the body of the subject.

Claims

1. Apparatus for PMR treatment, comprising:

an elongate probe having a distal end for engaging heart tissue of a subject, and comprising a revascularization device, which imparts energy to the heart tissue for generating perfusion-enhancing channels therein; and

a sensor, which provides an indication responsive to the treatment wherein the sensor comprises a blood flow sensor, which generate signals responsive to microcirculation.

2. Apparatus according to claim 1, wherein the sensor receives signals generated by the body of the subject responsive to the treatment.

3. Apparatus for PMR treatment, comprising:

an elongate probe having a distal end for engaging heart tissue of a subject, and comprising a revascularization device, which imparts energy to the heart tissue for generating perfusion-enhancing channels therein;

a sensor, which provides an indication responsive to the treatment; and

signal processing circuitry, which is coupled to the sensor and analyzes the signals to provide an indication of the efficacy of the treatment, wherein the circuitry detects an elevated ST segment.

4. Apparatus according to claim 3, wherein the sensor comprises an electrode.

5. Apparatus according to claim 4, wherein the electrode is positioned on the probe adjacent the distal end thereof.

6. Apparatus according to claim 3, wherein the sensor comprises an optical sensor.

7. Apparatus according to claim 6, and comprising a waveguide, which transmits fluorescence-stimulating radiation to the myocardial tissue, wherein the sensor receives fluorescence emitted from the tissue and generates signals responsive thereto.

8. Apparatus according to claim 3, wherein the revascularization device applies laser radiation to the heart tissue.

9. Apparatus according to claim 3, wherein the revascularization device applies RF energy to the heart tissue.

10. Apparatus according to claim 3, wherein the revascularization device applies high-intensity ultrasonic radiation to the heart tissue.

11. Apparatus according to claim 3, wherein the revascularization device applies mechanical energy to the heart tissue.

12. A method for monitored PMR treatment of the heart of a subject, comprising:

bringing a probe, including a revascularization device for imparting energy to the heart, into engagement with heart tissue of a subject;

imparting energy to the heart tissue using the device so as to generate perfusion-enhancing channels therein;

transmitting fluorescence-stimulating radiation to the heart tissue through an optical waveguide; and

receiving a signal from the body of the subject responsive to the treatment by receiving energy reflected from the heart tissue by receiving fluorescence radiation emitted from the heart tissue through a light detector.

13. A method according to claim 12, wherein receiving fluorescence radiation comprises receiving autofluorescent radiation.

14. A method according to claim 12, wherein receiving fluorescence radiation comprises receiving fluorescent radiation from an agent administered into the subject'"'"'s blood stream.

15. A method for monitored PMR treatment of the heart of a subject, comprising:

bringing a probe, including a revascularization device for imparting energy to the heart, into engagement with heart tissue of a subject;

imparting energy to the heart tissue using the device so as to generate perfusion-enhancing channels therein;

receiving a signal from the body of the subject responsive to the treatment; and

processing the signal to provide an indication of the efficacy of the treatment by detecting an elevated ST segment.

16. A method according to claim 15, wherein imparting energy to the heart comprises imparting laser radiation.

17. A method according to claim 15, wherein imparting energy to the heart comprises imparting RF radiation.

18. A method according to claim 15, wherein imparting energy to the heart comprises imparting high-intensity ultrasonic radiation.

19. A method according to claim 15, wherein imparting energy to the heart comprises imparting mechanical energy.

20. Apparatus for PMR treatment, comprising:

an elongate probe having a distal end for engaging heart tissue of a subject, and comprising a revascularization device, which imparts energy to the heart tissue for generating perfusion-enhancing channels therein;

a sensor, which provides an indication responsive to the treatment; and

signal processing circuitry, which is coupled to the sensor and analyzes the signals to provide an indication of the efficacy of the treatment, wherein the circuitry detects an arrhythmia, and wherein the arrhythmia detected by the circuitry comprises at least one VPB.

21. A method for monitored PMR treatment of the heart of a subject, comprising:

bringing a probe, including a revascularization device for imparting energy to the heart, into engagement with heart tissue of a subject;

imparting energy to the heart tissue using the device so as to generate perfusion-enhancing channels therein; and

receiving a signal from the body of the subject responsive to the treatment by receiving signals responsive to microcirculation blood flow rate adjacent a designated channel location within the heart.

22. A method for monitored PMR treatment of the heart of a subject, comprising:

bringing a probe, including a revascularization device for imparting energy to the heart, into engagement with heart tissue of a subject;

imparting energy to the heart tissue using the device so as to generate perfusion-enhancing channels therein;

receiving a signal from the body of the subject responsive to the treatment; and

processing the signal to provide an indication of the efficacy of the treatment by detecting an arrhythmia through detecting a VPB.